To analyze the trends in disease burden and risk factors of depression among the elderly population in China from 1990 to 2021, and to provide a theoretical basis for the prevention, treatment, and policy-making of geriatric depression in China.

Data on the disease burden of geriatric depression in China from 1990 to 2021, including the number of incident cases, disability-adjusted life years (DALYs), incidence rate, and DALY rate, were extracted from the 2021 Global Burden of Disease (GBD) database.The Joinpoint regression model was used to analyze the trends by calculating the annual percentage change (APC) and average annual percentage change (AAPC).The autoregressive integrated moving average (ARIMA) model was employed to predict the disease burden of geriatric depression over the next five years.Population attributable fractions (PAFs) were used to describe the risk factors for geriatric depression in China in 1990 and 2021.

From 1990 to 2021, the number of incident cases and the incidence rate of geriatric depression in China showed an overall upward trend.The most significant increase in incidence was observed in the 60-64 age group, while the prevalence rate increased notably in the ≥ 95 age group.TheDALY rate showed the most pronounced upward trend in the 65-69 age group.The incidence, prevalence, and DALY rates of geriatric depression were higher in women than in men.Major risk factors included child hood sexual abuse and intimate partner violence, with the impact of intimate partner violence being particularly significant among women.The ARIMA model predicted that the incidence, prevalence, and DALY rates of geriatric depression in China would decline over the next five years, with a greater decline observed in women than in men.

From 1990 to 2021, the incidence, prevalence, and DALY rates of geriatric depression in China showed an overall upward trend, with higher rates observed in women than in men.Greater attention should be paid to the elderly female population, with a focus on early prevention to reduce the disease burden of geriatric depression.

Ametropic visual impairment has become a public health problem in China and even in the world, especially the prevention and control of myopia development, and the Chinese government attaches great importances to the eye health of school-age children and adolescents.The establishment of visual health archives and the screening of refractive errors are important managements prevention and control.However, there has always been a lack of relevant domestic or international screening specifications, and which may result in screening implementation subject confusion, inconsistent screening indicators and boundary values, unscientific operation methods and feedback in the routine screening work in China.With the push and support of National Health Commission, a recommended national health standard Specification for Screening of Refractive Error in School-age Children and Adolescents (WS/T 663-2019) was officially issued on January 11, 2020 and will be implemented from June 1, 2020, which clarified the technical standardization for the specific requirement, methods, referral recommendation and management during screening of refractive error in school-age children and adolescents.Implementing an effective screening and prevention of ametropic visual impairment in school-age children and adolescents according to the standard is an important task and responsibility of medical and educational institutions.

Objective To analyze the clinical, imaging and interventional data of patients with chronic total occlusion (CTO) lesions without myocardial infarction (MI) and to summarize the clinical and imaging characteristics of these patients. Methods The data of 2651 patients with CTO verified by coronary angiography between January 1995 and December 2014 were analyzed retrospectively. Results There were 1466 CTO patients (55. 3%) without MI (the control group) and 1185 CTO patients (44. 7%) with MI ( the MI group). The age, percentage of female patients, unstable angina, hypertention, mean triglyceride levels, left ventricular ejection fraction ( LVEF) were lower in the MI group than in the control group ( all P﹤0. 05). The rates of heart failure and serum creatinine levels were higher in the MI group than the control group (both P﹤0. 05). The rate of multi-vessel disease was higher in the control group than in the MI group (81. 4% vs. 76. 5%, P﹤0. 05). According to the target CTO vessel location, patients in the control group had lower rates of CTO in LAD (36. 2% vs. 40. 7%, P=0. 007) and higher rates of CTO in LCX (17. 0%vs. 12. 7%, P﹤0. 001). Patients in the control group without MI had better collateral circulation than that in the control group (32. 7% vs. 27. 0%, P﹤0. 001). There were no differences in success rate of PCI and complete revascularization between the two groups. Conclusions The present study showed that the CTO patients without MI were associated with better collateral development compared with the CTO patients with MI. Age, gender, unstable angina encouraging ischemic preconditioning and hypertension may be beneficial by facilitating collateral development through endogenous cardioprotective mechanisms.

Objective To observe the clinical efficacy of acupuncture plus contralateral needling in treating post-stoke myodystonia. Method Totally 120 patients with post-stroke myodystonia were randomized into group A, B, C and D, 30 in each group. Group A was intervened by yin-reducing and yang-tonifying needling method plus contralateral needling; group B was by ordinary acupuncture plus contralateral needling, group C was by yin-reducing and yang-tonifying needling alone, while group D by ordinary acupuncture. Clinical Spasticity Index (CSI) was observed before and after intervention. Result After treatment, the CSI scores (tendon reflex, muscle tension, episodic spasm scores and total score) were significantly changed in the four groups (P<0.01, P<0.05). The tendon reflex score, muscle tension score and total score in group A were significantly different from that in the other three groups after intervention (P<0.01,P<0.05). There was a significant difference in comparing the episodic spasm score between group A and D after intervention (P<0.01). There were significant differences in comparing the tendon reflex score, muscle tension score and total score between group B and D after intervention (P<0.05). The total score in group C was markedly different from that in group D after intervention (P<0.05). Conclusion Yin-reducing and yang-tonifying needling method plus contralateral needling is an effective method in treating post-stroke myodystonia.

Objective To study the effect of biodegradable polymer drug-eluting stents (DES) on maintenance hemodialysis (MHD) patients with acute coronary syndrome. Methods From 2008 January to 2013 July, a total of 100 MHD patients with ACS who were treated with PCI in our centre were randomly divided into two groups, 50 patients in the EXcellstent group (biodegradable polymer DES) and the others in the FIREBIRD stent group (Ordinary DES). The patients included 61 male and 39 female, while the mean age was (58.4±9.2) years old (43-74 years old). After procedure, the EXcellstent group patients took aspirin (100 mg qd) and clopidogrel (75 mg qd) for 6 months, then aspirin (100 mg qd) for lifelong. The FIRDBIRD stent group patients also took aspirin (100 mg qd) and clopidogrel (75 mg qd), then aspirin (100 mg qd) lifetime too. To observe the main adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events during 12 months after procedure. Results The clinical data and angiographic results had no significant difference. No MACCE occurred during hospitalization. In 12 months after PCI, MACCE had no significant difference between two groups (P>0.05), and no stent thrombosis occured. One patient presented gastroin testinal bleeding in the EXcellgroup and 2 patients had cerebral hemorrhage in the FIRBIRD group. FIRBIRD group had more total hemorrhages events than that in EXcellgroup (P<0.05). Conclusions The treatment of biodegradable polymers DES in MHD patients with ACS was effective, and dual anti-platelet for 6 months was safe.

Objective To observe the efifcacy and safety of ticagrelor in patients received percutaneous coronary intervention (PCI). Methods 50 patients with non-responding platelet aggregation rate and CYPC219 gene after clopidogrel treatment were given ticagrelor and enrolled in the study. All enrolled patients received aspirin loading dosage 300 mg, followed by maintenance dosage 100 mg, once daily and ticagrelor maintenance dosage 90 mg twice daily, for 1 year. The primary endpoint for the study were the incidence of major cardiovascular events (including death, stent thrombosis, stent restenosis, nonfatal myocardial infarction, target vessel revascularization) and stroke after followed up for a month. The secondary endpoint were the incidence of general events (including minor bleeding, allergies, breathing dififculties) and platelet count changes. Results No occur major cardiovascular and stroke events record after 1 month of ticagrelor treatment. The general events rates included 2 cases of dyspnen, 1 case of epitaxis and 1 case of subcutaneous bleeding. The platelet aggregation with ticagrelor was signiifcantly lower than clopidogrel without signiifcant decrease in platelets count. Conclusions Using ticagrelor for antiplatelet in patients with coronary artery stenting in clopidogrel resistance cases is safe and effective.

BACKGROUNDThe occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality. The aim of the present study was to appraise the diagnostic efficacy of age, estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml × min(-1)× 1.73 m(-2))) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).

METHODSThe AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography. CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium. Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles. The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.

RESULTSThe AGEF score ranged from 0.49 to 3.09. The AGEF score tertiles were defined as follows: AGEFlow ≤ 0.92 (n = 1 006); 0.92 1.16 (n = 992). The incidence of CIAKI was significantly different in patients with low, middle and high AGEF scores (AGEFlow = 1.1%, AGEFmid = 2.3% and AGEFhigh = 5.8%, P < 0.001). By multivariate analysis, AGEF score was an independent predictor of CIAKI (odds ratio = 4.96, 95% CI: 2.32-10.58, P < 0.01). ROC analysis showed that the area under the curve was 0.70 (95% CI: 0.648-0.753, P < 0.001).

CONCLUSIONThe AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography. (Clinical Trial identifier: NCT00786136).

Acute Kidney Injury ; physiopathology ; Contrast Media ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Renal Insufficiency, Chronic ; physiopathology

ObjectiveTo evaluate the long-term efficacy of covered stent implantation in the treatment of elderly patients with coronary perforation while undergoing percutaneous coronary intervention (PCI).MethodsFrom June 2004 to June 2012, our center has followed ten elderly patients (age≥ 60 years) who sustained coronary perforation during PCI. The major adverse cardiac events (MACE) were observed as well. The patients were advised to take 75 mg/day Clopidogrel for two years, and indefinite use of 100 mg/day enteric-coated aspirin.ResultsSix out of the 10 patients aged from 60 to 76 years old (mean 68.6 ± 5.2 years) were male, four were female. The average diameter of the implanted stents was 3.3 ± 0.3 mm, and the average length was 22.1 ± 3.7 mm. All the ruptures were successfully sealed without intra-procedural death. The follow-up duration ranged from 0.6 to 67 months (mean 31.7 ± 24.5 months). One patient died of multiple organ failure due to lung infection in 19 days after PCI; one died of cardiac sudden death in 13 months after PCI; one had angina pectoris in 53 months after PCI; one underwent multi-slice CT examination in six months after PCI, and no in-stent restenosis was found. The other four patients received angiography follow-up, and the results showed that three patients had no intra-stent restenosis, while one had left anterior descending (LAD) restenosis in the covered stent in 67 months after PCI. The in-hospital mortality was 10% (1/10). The MACE rate in 12 months after PCI was 10% (1/10). During the entire followed-up period, the restenosis rate in target vessels was 20% (1/5), mortality was 20% (2/10), and the MACE rate was 40% (4/10).ConclusionTreatment of coronary perforation by using covered stents can achieve favorable long-term results; a two-year dual antiplatelet therapy (DAPT) after PCI can effectively prevent intra-stent thrombosis.

OBJECTIVETo investigate the molecular mechanisms of diaphragm injury in rats with liver cirrhosis.

METHODSThirty adult male Sprague-Dawley rats were randomized into control group (n=10) and carbon tetrachloride-induced liver cirrhosis group (LC group, n=20). In the 9th week, the rat body weight and diaphragm to body weight ratio were measured, and the parameters of diaphragm contractility including peak twitch tension (Pt), maximum tetanic tension (Po), time to peak contraction (CT), half relaxation time (1/2RT), and force-frequency curve were assessed using a Medlab-U/4C biological signal collecting system. The activities of superoxide dismutase (SOD), succinic dehydrogenase (SDH) and myeloperoxidase (MPO) and malondiadehyde (MDA) content in the diaphragm were detected. The mRNA expression levels of sarcoplasmic reticulum calcium ATPase (SERCA) and cytoskeletal proteins (titin and nebulin) in the diaphragm were detected by RT-PCR, and the diaphragm ultrastructure was examined with electron microscopy.

RESULTSCompared with those in the control group, body weight, diaphragm to body weight ratio, Pt, Po, and tetanic force under the stimulus frequency of 10, 20, 40, 60, 100 Hz were all significantly decreased (P<0.01), while CT and 1/2RT were significantly prolonged in LC group (P<0.01). SOD and SDH activities were significantly lowered (P<0.01) while the contents of MDA and MPO activity were significantly increased in LC group (P<0.01) with significantly decreased SERCA, titin and nebulin mRNA expressions in the diaphragm (P<0.01). Electron microscopy of the diaphragm in LC group revealed myofibrillar degeneration, absence of the Z line, and mitochondria swelling and edema.

CONCLUSIONLiver cirrhosis increases free radicals and aggravates inflammatory response and lipid peroxidation in the diaphragm, thus leading to mitochondrial damages and decreased expressions of cytoskeletal proteins and SERCA to cause diaphragmatic dysfunction.

Animals ; Body Weight ; Carbon Tetrachloride ; Connectin ; metabolism ; Diaphragm ; metabolism ; Lipid Peroxidation ; Liver ; enzymology ; pathology ; Liver Cirrhosis ; metabolism ; Male ; Muscle Contraction ; Muscle Proteins ; metabolism ; Oxidation-Reduction ; Rats ; Rats, Sprague-Dawley ; Sarcoplasmic Reticulum Calcium-Transporting ATPases ; metabolism